This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Individuals developing chronic kidney disease (CKD) during childhood develop premature and accelerated cardiovascular disease, particularly those who progress to end-stage renal disease (ESRD)(1-6). Dyslipidemia may play a role both in the progression of CKD itself and in the genesis of cardiovascular disease. Hypertriglyceridemia develops with chronic renal insufficiency (CRI) in large part due to impaired triglyceride catabolism. Certain factors appear to promote this abnormality, including elevated apolipoprotein (apo) C-III and altered insulin sensitivity. The post-prandial response to a high-fat mixed meal is an experimental approach well suited to the study of lipoprotein metabolism and insulin sensitivity in CRI. Hypothesis: Children and young adults with CRI have delayed post-prandial triglyceride clearance. Secondary hypotheses include: post-prandial triglyceride clearance is related to fasting triglyceride levels, insulin resistance, apoC-III levels, the degree of renal insufficiency, and specific genetic influences.